1. Field of the Invention
The present invention relates to a hand-held pulsating jet lavage and, more particularly, to an improved jet lavage in which a motor for driving a pulsating fluid pump is mounted within the hand-held housing of the jet lavage and in which the tubing for passing the pulsating fluid is rigid to assure sharp turn-on, cut-off interfaces between the respective pulses.
2. Description of the Prior Art
It is known in the prior art that the use of a pulsating stream of fluid, such as water, can be utilized to cleanse body tissue of contaminates. A well-known example of this is a pulsating device utilized to cleanse the teeth and gums. Such a device is shown in U.S. Pat. No. 3,227,158, issued Jan. 4, 1966, by J. W. Mattingly. This apparatus suffered from a few problems. For one, the motor that provides the energy to pulse the cleansing fluid is mounted within a counter-top container at a substantial distance from the nozzle which delivers the pulsating fluid. When the device is to be used by a surgeon to clean a surgical site, for example, the motor and other major components of the device must be located outside the sterile field surrounding the surgeon and patient. This places the sterile field in jeopardy. A second problem with this apparatus is that there is no adequate arrangement to deliver sterile fluid to the surgical site.
In many devices, the nozzle for fluid delivery is connected to the fluid container by a tube whose flexibility causes a significant deterioration of the turn-on, cut-off interfaces between pulses. See for example, U.S. Pat. No. 3,393,673, which issued July 23, 1968, by J. W. Mattingly; U.S. Pat. No. 3,425,410, which issued Feb. 4, 1969, by M. A. Cammack; and U.S. Pat. No. 3,993,054, which issued Nov. 23, 1976, by G. A. Newman for a therapeutic lavage. The Newman patent relies upon a long and flexible tube to connect its counter-top fluid receptacle to a nozzle. The flexible tube in this device causes the cleansing fluid to be delivered to the body tissue without the sharp interface between pulses originally envisioned.
In the medical profession, many articles have been written noting the advantages of a pulsating jet lavage for the treatment of contaminated wounds. In one paper by Gross, Cutright, and Bhasker, entitled "Effectiveness of Pulsating Water Jet Lavage in Treatment of Contaminated Crushed Wounds," The American Journal of Surgery, September 1972, Volume 124, pp. 373-377, the authors' reported on experimentation wherein facial crush wounds were treated with contaminated soil containing bacteria and then lavaged. The control group was irrigated with water using a bulb syringe, while the experimental group was lavaged with a pulsating water jet. The results indicated that the pulsating jet lavage was much more effective in reducing bacterial population and in the removal of necrotic tissue and foreign particles from the wounds than was irrigation with the bulb syringe.
In addition to wound cleansing, the pulsed jet lavage is also useful in total hip replacement surgery. In this application, the pulsed jet lavage is used to remove debris from the intermedullary canal and acetabulum. See the paper by Amstutz, "Femoral Looseness in THR Using Conventional Cement Techniques," Orthopaedic Review, May 1980, Vol. IX, No. 5, pp. 33-37.
Yet, another use for pulsating jet lavage is to reduce the trauma caused by the introduction of cement into a bored channel formed within the intermedullary canal of the femoral tip prior to insertion of a prosthesis. It has been found that the introduction of cement into the intermedullary canal causes an increase in blood gas with an accompanying decrease in intrapulmonary shunt fraction and pulmonary artery pressure. By the careful lavage of the plugged intermedullary canal prior to the insertion of the cement, the elimination of gas-exchange and hemodynamic complications can be achieved. See the article by Sherman, Byrick, Kay, Sullivan, and Waddell, entitled "The Role of Lavage in Preventing Hemodynamic and Blood-Gas Changes during Cemented Arthroplasty," The Journal of Bone and Joint Surgery, Inc., April 1983, Volume 65-A, No. 4, pp. 500-505.